Testing the Effect of an Interactive Narrative: The Mediating Role of Transportation and the Moderating Roles of Narrative Ending and Issue Involvement

There has been a growing literature focusing on the persuasive effect of interactive narratives, but the findings are mixed. Furthermore, very few studies have examined how the impact of interactive narratives varies depending on story features and characteristics of the recipients. Informed by the research of interactive narratives and message framing, the current study empirically tests the indirect effect of an interactive narrative on attitude change using a digital anti-indoor tanning game, with transportation as a mediator and narrative ending and issue involvement as two second-stage moderators. Findings suggested a moderated moderated mediation relationship in which the indirect effect of the interactive narrative was the strongest for low-involvement participants when they experienced a loss-framed ending and was the weakest for high-involvement participants when they encountered the same type of ending. Theoretical and practical implications were discussed.

Different Frames to Reduce Red Meat Intake: The Moderating Role of Self-Efficacy

Previous research has shown that messages aimed at reducing red meat intake often do not have the expected effect. In the present study, we tested whether prefactual ("If… then") or factual messages focused on health or wellbeing concerns have different persuasive effects depending on the recipient's level of eating self-efficacy. Young adult participants (N = 247) completed a questionnaire measuring their eating self-efficacy and current red meat consumption. They were then presented with a prefactual or factual version of a message describing the possible negative impact of excessive red meat consumption on either health or wellbeing. After reading the message participants reported their involvement with the message and intention to eat red meat in the future. Results showed that prefactual wellbeing messages and factual health messages trigger participants' involvement and, in turn, reduce their intention to eat red meat more than the other message combinations. Eating self-efficacy moderates these effects, with factual health messages persuading people with high self-efficacy and prefactual wellbeing messages persuading also receivers with an average level of self-efficacy. Discussion focuses on which message frames can be more effective in promoting a reduction in red meat consumption in a wider population.

Effects of Goal-Framed Messages on Mental Health Education Among Medical University Students: Moderating Role of Personal Involvement

Mental health problem among university students is an emerging public health issue, and mental health education has always been the focus of attention for universities. However, limited attention has been paid to the effect of students' acceptance of health messages. Previous studies have found that message framing plays a key role in the process of responding to health-promoting messages. In this backdrop, the study aimed to examine the effects of goal-framed messages on mental health education among medical university students and investigate the moderating role of personal involvement. A cross-sectional study was conducted on medical university students. An online self-administered questionnaire was used to collect data. Wilcoxon rank-sum test and ordinal logistic regression were used for data analysis. Results showed significant differences in message acceptance between the gain- and loss-framed groups (p < 0.001). Participants with high personal involvement had higher message acceptance than those with low personal involvement in gain- and loss-framed message models (p < 0.05). Specifically, participants who related to roommates with high intimacy had higher message acceptance than those who related to roommates generally (p < 0.05). Participants who were concerned about their health condition had higher message acceptance than those who were neutral about their health condition (p < 0.001). Evidence of advantages of gain- over loss-framed messages on mental health among medical university students was found. The hypothesis that personal involvement with a health issue affects the acceptance of message framing was supported. Public health advocates can use framed message as a strategy to improve the efficacy of intervention in mental health education.

Is the news making us unhappy? The influence of daily news exposure on emotional states

There is evidence that exposure to negative news is making people feel bad, but not much is known about why this only affects some people or whether this also applies to everyday news exposure. This study examined the direct and indirect effects of daily news exposure on people's affective states. Using ecological momentary assessment (EMA), 63 respondents (24 men and 39 women) reported their news exposure and affective states five times a day for 10 days. In addition, personal relevance of the news and personality characteristics, neuroticism and extraversion, were assessed. Results showed that negative news perceptions were related to more negative affect and less positive affect, and these effects were moderated by personal relevance, but not personality characteristics. The implications of these outcomes are discussed.

Investigating the impact of a health game on implicit attitudes towards food and food choice behaviour of young adults

Improving diets by stimulating fruit and vegetable consumption might be beneficial, in particular when they substitute energy-dense products. The aim of present study was to investigate whether a health game can be used to positively affect healthy implicit attitudes (IAs) towards food and subsequent food choice behaviour of young adults. A 2 (Time: baseline vs. post-test) x 2 (Condition: health game vs. control game) x 2 (Baseline IAs: healthy IAs vs. less healthy IAs) mixed-subjects design was used with 125 participants (age: M = 20.17, SD = 1.88). IAs towards food were assessed at baseline and post-test using an Implicit Association Test (IAT). Additionally, food choice behaviour was assessed after game play. At baseline, the majority of participants had healthy IAs (i.e., favouring fruit over chocolate snacks). At post-test, significantly less healthy IAs were observed in the control condition, while this reduction was not significant in the health game condition. Regarding food choice behaviour, participants with healthy baseline IAs were more likely to select fruit in the health game condition than participants with healthy baseline IAs in the control game condition. However, participants with less healthy baseline IAs were less likely to select fruit in the health game condition than in the control condition. We found tentative support that health games can be used to influence IAs towards food and positively affect food choice behaviour. However, this influence was only observed for those with healthy baseline IAs. The current version of the health game would primarily benefit those already healthy and could negatively affect those that need the intervention most, so modifications are recommendable.

Temporal Consequences, Message Framing, and Consideration of Future Consequences: Persuasion Effects on Adult Fruit Intake Intention and Resolve

Message framing is a persuasive strategy that has seen mixed evidence for promoting fruit intake intentions, potentially because framed messages for fruit intake have not (a) explicitly compared short-term consequences versus long-term consequences, (b) considered individual-level differences in time perspective, and (c) used alternative measures of fruit intake intentions. In the present online study, the effects of persuasive messages created from temporal context (short term vs. long term) and message frame (gain framed vs. loss framed) were investigated on fruit intake intentions and resolve among a sample of Dutch adults who were categorized as either present oriented or future oriented. For intention and resolve, results showed a significant Type of Frame × Type of Temporal Context interaction, such that gain-framed messages were more persuasive when combined with long-term consequences and loss-framed messages were more persuasive when combined with short-term consequences. The effect sizes for these differences were similar for resolve and intention, but only differences for intentions were significant. No other effects were found. These results demonstrate that message framing theory may usefully consider the inclusion of temporal context of outcomes and alternative motivation measures to maximize their persuasive effects.

Framing preventive care messaging and cervical cancer screening in a health-insured population in South Africa: Implications for population-based communication?

The impact of health message framing on cervical cancer screening uptake is poorly understood. In a prospective randomized control study with 748 females, aged 21–65 years with no Pap smear in the previous 3 years, they randomly received a loss-framed, gain-framed, or neutral health message (control) regarding cervical cancer screening by email. Screening rate in the control group was 9.58 percent (CI: 9.29%–9.87%), 5.71 percent (CI: 5.48%–6.98%) in the gain-framed group, and 8.53 percent (CI: 8.24%–8.81%) in the loss-framed group. Statistically there was no difference between the three screening rates. Framing of health messages may not be a significant consideration when communicating through emails.

Effects of Previous Fruit Intake, Descriptive Majority Norms, and Message Framing on Fruit Intake Intentions and Behaviors in Dutch Adults Across a 1-Week Period

OBJECTIVE

To test the effects of descriptive norm and message framing on fruit intake (intentions) in Dutch adults.

DESIGN

Randomized pretest-posttest study using a 2 × 2 design.

SETTING

Internet-based.

PARTICIPANTS

Dutch adults recruited via leaflets and announcements on intranet and Internet and who provided immediate intention (n = 294) and 1-week follow-up intention and fruit intake data (n = 177).

INTERVENTION

Messages combining information on intake of others (low vs high intake) with information about positive or negative outcomes of (in)sufficient fruit intake.

MAIN OUTCOME MEASURES

Fruit intake intentions and fruit intake.

ANALYSIS

Analyses of covariance.

RESULTS

Those already consuming sufficient fruit and receiving negative information about insufficient fruit intake increased their motivation to consume sufficient fruit immediately (P = .03), but not at 1-week follow-up. Those who read positive information about sufficient fruit intake reported higher fruit consumption than those who read negative information about insufficient fruit intake (P = .03). This was stronger in those already consuming sufficient fruit. There were no effects of descriptive norm information (P > .19).

CONCLUSIONS AND IMPLICATIONS

Information about outcomes was more persuasive than descriptive majority norm information. Effects were generally stronger in those already consuming sufficient fruit.

Cognitive biases and heuristics in medical decision making: a critical review using a systematic search strategy

BACKGROUND

The role of cognitive biases and heuristics in medical decision making is of growing interest. The purpose of this study was to determine whether studies on cognitive biases and heuristics in medical decision making are based on actual or hypothetical decisions and are conducted with populations that are representative of those who typically make the medical decision; to categorize the types of cognitive biases and heuristics found and whether they are found in patients or in medical personnel; and to critically review the studies based on standard methodological quality criteria.

METHOD

Data sources were original, peer-reviewed, empirical studies on cognitive biases and heuristics in medical decision making found in Ovid Medline, PsycINFO, and the CINAHL databases published in 1980-2013. Predefined exclusion criteria were used to identify 213 studies. During data extraction, information was collected on type of bias or heuristic studied, respondent population, decision type, study type (actual or hypothetical), study method, and study conclusion.

RESULTS

Of the 213 studies analyzed, 164 (77%) were based on hypothetical vignettes, and 175 (82%) were conducted with representative populations. Nineteen types of cognitive biases and heuristics were found. Only 34% of studies (n = 73) investigated medical personnel, and 68% (n = 145) confirmed the presence of a bias or heuristic. Each methodological quality criterion was satisfied by more than 50% of the studies, except for sample size and validated instruments/questions. Limitations are that existing terms were used to inform search terms, and study inclusion criteria focused strictly on decision making.

CONCLUSIONS

Most of the studies on biases and heuristics in medical decision making are based on hypothetical vignettes, raising concerns about applicability of these findings to actual decision making. Biases and heuristics have been underinvestigated in medical personnel compared with patients.

Testing the effects of message framing, kernel state, and exercise guideline adherence on exercise intentions and resolve

OBJECTIVES

To study the effects of framed messages on exercise intention and resolve.

DESIGN

Two (type of frame: gain or loss) × 2 (type of kernel state: desirable or undesirable outcome) post-test study.

METHODS

Participants were recruited online and questioned about their previous exercise behaviour and their exercise risk perception. After this, they were randomly allocated to one of four messages that were different in terms of positive or negative outcomes (type of frame) and in terms of attained or avoided outcomes (type of kernel state). After reading the message, participants indicated their intention and resolve to engage in sufficient exercise.

RESULTS

No effects were found for intention. For resolve, there was a significant interaction between type of frame, type of kernel state, and exercise adherence. Those who did not adhere to the exercise guideline and read the loss-framed message with attained outcomes reported significantly higher resolve than all other participants.

CONCLUSIONS

This study indicates the relevance of including attained outcomes in message framing exercise interventions as well as a focus on exercise resolve.

STATEMENT OF CONTRIBUTION

What is already known on this subject? Message framing is commonly used to increase exercise intentions and behaviour. Meta-analyses do not provide consistent support for this theory. Very little attention has been paid to resolve and message factors on framing effects. What does this study add? Framed messages have an effect on exercise resolve, but not on intention. Loss-framed messages with attained outcomes are most persuasive for those who do not adhere to exercise guidelines. Exercise framing studies should include behavioural resolve next to intention. .

Media exposure and smoking intention in adolescents: a moderated mediation analysis from a cultivation perspective

The study tested a moderated mediation model to examine the mechanisms underlying the link between media exposure and adolescent smoking intention by utilizing a modification of cultivation theory. A total of 12,586 non-current smoker adolescents in California were included in the analysis. Results showed that media exposure was positively related to smoking intention via perceived prevalence of peer smoking when friend disapproval of cigarette use was low. This study contributes to a better understanding of the mechanisms regarding the media effects on smoking intention, but the findings should be interpreted with caution due to the small effect size.